The Aboriginal Health Council of Western Australia says "crucial IT communication issues" need to be understood in the context of continuing reliance on satellite in remote areas excluded from the National Broadband Network.
The forthcoming rollout of the $500 million personally controlled e-health record system will put further strain on existing infrastructure, the council says in a submission on the PCEHR bill introduced into parliament last month.
"Decision-makers need to recognise a problem of saturation which comes about because we are putting the PCEHR on top of email, government Aboriginal and Torres Strait Islander health systems and the online community health reporting environment, OCHREStream," says the council, which represents 19 local health services in WA.
"The current hardware is basic in comparison to metropolitan-based providers and extra data loads will lead to saturation of the current data connections.
"Indeed some of our sector participants fear the PCEHR will slow emails and basic internet services within the Aboriginal Medical Services' communications system.
"Electronic communications are intermittent, and regular transmission and receipt of PCEHR-related data could be affected by the loss of connectivity common in remote areas."
The council believes the installation of high-end routers and wide area network optimisation hardware would help to overcome these problems, and has called for funding.
"As long as we remain reliant on satellite and other regional internet access services, these new IT business hardware systems are essential," it says.
"Without optimisation hardware, a substantial number of indigenous populations are going to be disadvantaged in the expected everyday usage of the PCEHR."
The investment would also reap "unintended benefits", including video-conferencing capabilities and improved follow-up care.
However, the submission says there are also issues to be resolved over software compatibility and funding for installation, licensing costs, modification of existing software and maintenance. "For Aboriginal Medical Services trying to deliver optimal services with minimal resources, our sector would benefit from a budgetary allocation to support the implementation process," it says.
Questions about e-health service delivery in remote areas have also been raised through the inquiries into the progress and performance of the NBN.
The Royal Flying Doctor Service has warned that currently available IT facilities are "unsatisfactory and are compromising patient care".
"The already disadvantaged communities that we serve are falling even further behind," the service said in a recent submission to the Joint Committee on the NBN inquiry.
"Four years ago, we embarked on a wireless broadband electronic records system, which provides remote clinicians with access to current patient records.
"At the time, our medical providers were probably the only local users accessing data over wireless systems, but today's influx of smart phones and devices means the bandwidth we need is no longer available.
"Our doctors report the wireless broadband speed is becoming slower and slower, even though the signal strength is adequate," the service said.
The service has been advised that voice calls take priority over data on country cell towers, "so this may be a significant factor".
Staff at remote clinics now lose around 30 minutes each day in productivity due to the slowness of the system, compared with a savings of 60 minutes each day when the system started.
In south-eastern NSW, the flying doctor service says, the NBN is planned to pass through Wilcannia, yet there are no plans to establish a node there.
"In fact, there is only one node proposed for the whole 640,000sq km that we cover (in that region), at Broken Hill," it said.
"A node at Wilcannia as well would significantly improve broadband coverage, which would allow us to introduce a range of health initiatives."
Ninti One, the Alice Springs-based Desert Knowledge co-operative research centre spin-off, says the current NBN plan offers "less than satisfactory bandwidth for remote communities".
"Fibre will have symmetric speeds of up to 100Mbps, while remote Australia will receive asymmetric rates up to 12Mbps when connected via satellite and wireless solutions," it said.
"This limits access to e-government services such as e-health, and it also has significant implications in terms of local business and employment development."
Meanwhile, the Senate Community Affairs committee has started a broad-ranging public inquiry into the PCEHR Bill, intended to support the launch of the new national e-health records system on July 1 next year.
Submissions on the legislation, the system's design and operational aspects, and the performance of the National E-Health Transition Authority in delivering the program, are invited by January 12.
The committee is due to report by February 29.
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Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 06.12.2011
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